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Blue Cross Idaho Medical Policy Updates – May 2018
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May 2018 Medical Policy Updates:
- MP 1.01.03 – Transtympanic Micropressure Applications as a Treatment of Meniere`s Disease
- MP 1.01.16 – Negative Pressure Wound Therapy in the Outpatient Setting
- MP 1.01.20 – Continuous or Intermittent Monitoring of Glucose in Interstitial Fluid
- MP 1.01.26 – Cooling Devices Used in the Outpatient Setting
- MP 1.01.27 – Electrical Stimulation for the Treatment of Arthritis
- MP 1.01.28 – Postsurgical Use of Limb Compression Devices for Venous Thromboembolism Prophylaxis
- MP 1.01.500 – Stretching Devices for the Treatment of Joint Stiffness and Contracture
- MP 1.01.510 – Continuous Passive Motion in the Home Setting
- MP 1.01.529 – Tumor-Treatment Fields Therapy for Glioblastoma
- MP 1.03.05 – Patient-Controlled End of Range Motion Stretching Devices
- MP 10.01.500 – COST EFFECTIVE MEDICAL DRUGS
- MP 10.01.501 – Breast Pump Rental
- MP 10.01.510 – Robotic-Assisted Surgery
- MP 2.01.02 – Dynamic Posturography
- MP 2.01.104 – Vestibular Function Testing
- MP 2.01.201 – Transgender Services
- MP 2.01.21 – Temporomandibular Joint Dysfunction
- MP 2.01.47 – Light Therapy for Psoriasis
- MP 2.01.531 – Intra-articular Hyaluronan Injections for Osteoarthritis
- MP 2.01.54 – Endovascular Procedures for Intracranial Arterial Disease (Atherosclerosis and Aneurysms)
- MP 2.01.77 – Automated Point-of-Care Nerve Conduction Tests
- MP 2.01.93 – Antigen Leukocyte Antibody Test
- MP 2.01.94 – Epidural Steroid Injections for Back Pain
- MP 2.02.28 – Genetic Testing
- MP 2.04.103 – Genetic Testing for Macular Degeneration
- MP 2.04.132 – Mutation Testing For Limb-Girdle Muscular Dystrophies
- MP 2.04.144 – Gene Therapy for Inherited Retinal Dystrophy
- MP 2.04.44 – Genetic Testing for Familial Cutaneous Malignant Melanoma
- MP 2.04.500 – Unproven and Inappropriate Diagnostic Tests for Allergic and Immune Deficiency Diseases
- MP 2.04.54 – Gene Expression-Assays for Cancers of Unknown Primary
- MP 2.04.62 – Proteomics-based Testing Related to Ovarian Cancer
- MP 2.04.68 – Laboratory and Genetic Testing for Use of 5-Flourouracil in Patients With Cancer
- MP 2.04.72 – Gene Expression Testing to Predict Coronary Artery Disease
- MP 2.04.78 – Molecular Markers in Fine Needle Aspirates of the Thyroid
- MP 2.04.84 – Measurement of Serum Antibodies to Infliximab and Adalimumab
- MP 2.04.93 – Genetic Cancer Susceptibility Panels Using Next Generation Sequencing
- MP 5.01.28 – Nusinersen for Spinal Muscular Atrophy
- MP 5.01.505 – Botulinum Toxin
- MP 5.01.608 – Pharmacologic Treatment of Hereditary Angioedema
- MP 5.01.650 – Pharmacologic Compounds
- MP 6.01.46 – Dynamic Spinal Visualization
- MP 7.01.102 – Periureteral Bulking Agents as a Treatment of Vesicoureteral Reflux
- MP 7.01.106 – Posterior Tibial Nerve Stimulation
- MP 7.01.132 – Transcatheter Aortic Valve Implantation for Aortic Stenosis
- MP 7.01.135 – Surgical Deactivation of Headache Trigger Sites
- MP 7.01.145 – Laminectomy
- MP 7.01.146 – Discectomy
- MP 7.01.48 – Autologous Chondrocyte Implantation for Focal Articular Cartilage Lesions
- MP 7.01.541 – Lumbar Spine Fusion
- MP 7.01.85 – Electrical Stimulation of the Spine as an Adjunct to Spinal Fusion Procedures
- MP 8.01.01 – Adoptive Immunotherapy
- MP 8.01.17 – Hematopoietic Stem-Cell Transplantation for Plasma Cell Dyscrasia
- MP 8.02.04 – Lipid Apheresis
- MP 8.03.502 – Authorization Criteria for Outpatient Physical Therapy
- MP 9.01.02 – Experimental/Investigational Services
- PAP 100 – Contact Information
- PAP 205 – Referring Provider Number Requirements
- PAP 224 – Place of Service
- PAP 241 – Prior Authorization Requirements
- PAP 265 – Diagnostic Testing in a Hospital Setting
- PAP 287 – Required Use of Participating Laboratories
Added 6/01/2018;
- MP 1.01.03 – Transtympanic Micropressure Applications as a Treatment of Meniere`s Disease
- MP 10.01.510 – Robotic-Assisted Surgery
- MP 2.01 – Medicine Introduction
- MP 2.01.02 – Dynamic Posturography
- MP 2.01.100 – Dry Needling of Myofascial Trigger Points
- MP 2.01.103 – Trigger Point and Tender Point Injections
- MP 2.01.104 – Vestibular Function Testing
- MP 2.01.21 – Temporomandibular Joint Dysfunction
- MP 2.01.501 – Transgender Services
- MP 2.01.504 – Hyperbaric Oxygen Pressurization
- MP 2.01.550 – Transcranial Magnetic Stimulation as a Treatment of Depression and Other Psychiatric/Neurologic Disorders
- MP 2.01.77 – Automated Point-of-Care Nerve Conduction Tests
- MP 2.01.83 – Interventions for Progressive Scoliosis
- MP 2.01.98 – Orthopedic Applications of Platelet-Rich Plasma
- MP 2.04 – Pathology/Laboratory Introduction
- MP 2.04.100 – Cardiovascular Risk Panels
- MP 2.04.125 – Proteomic Testing for Targeted Therapy in Non-Small-Cell Lung Cancer
- MP 2.04.13 – Genetic Testing for Familial Alzheimer Disease
- MP 2.04.136 – Nutrient/Nutritional Panel Testing
- MP 2.04.500 – Unproven and Inappropriate Diagnostic Tests for Allergic and Immune Deficiency Diseases
- MP 2.04.501 – Laboratory Diagnostic Testing
- MP 2.04.523 – Homocysteine Testing in the Screening, Diagnosis, and Management of Cardiovascular Disease and Venous Thro
- MP 2.04.582 – Genetic Testing for Inherited Thrombophilia
- MP 2.04.598 – Urine Drug Testing in Pain Management and Substance Abuse Treatment
- MP 2.04.72 – Gene Expression Testing to Predict Coronary Artery Disease
- MP 2.04.75 – Genetic Testing of CADASIL Syndrome
- MP 2.04.87 – Genetic Testing for Hereditary Hearing Loss
- MP 2.04.93 – Genetic Cancer Susceptibility Panels Using Next Generation Sequencing
- MP 3.01.501 – Guidelines for Coverage of Mental and Behavioral Health Services
- MP 3.01.597 – Psychological and Neuropsychological Testing in Young Children with Suspected Autism
- MP 3.02 – Substance Abuse Introduction
- MP 3.02 – Substance Abuse Introduction
- MP 3.02.501 – Methadone Treatment for Opiate Addiction
- MP 4.02.510 – Genetic Testing for Recurrent Pregnancy Loss
- MP 5.01.08 – Intravenous Antibiotic Therapy and Associated Diagnostic Testing for Lyme Disease
- MP 5.01.501 – Guidelines for Prior Authorization of Pharmacologic Therapies
- MP 5.01.509 – Advanced Therapies for Pharmocological Treatment of Pulmonary Hypertension
- MP 5.01.515 – Infliximab
- MP 5.01.519 – Injectable Clostridial Collagenase for Fibroproliferative Disorders
- MP 5.01.520 -Letermovir (Prevymis) for Cytomegalovirus Prophylaxis in Hematopoietic Stem Cell Transplant Patients
- MP 5.01.593 – Specialty Drugs
- MP 5.01.605 – Intravenous Iron Therapy
- MP 5.01.609 – Implantable Hormone Pellets
- MP 5.01.611 – Eculizumab (Soliris)
- MP 5.01.612 – Use of Sodium Oxybate (XYREM®)
- MP 5.01.650 – Pharmacologic Compounds
- MP 6.01.25 – Percutaneous Vertebroplasty and Sacroplasty
- MP 6.01.38 – Percutaneous Balloon Kyphoplasty and Mechanical Vertebral Augmentation
- MP 6.01.46 – Dynamic Spinal Visualization
- MP 7.01 – Surgery Introduction
- MP 7.01.07 – Electrical Bone Growth Stimulation of the Appendicular Skeleton
- MP 7.01.100 – Bone Morphogenetic Protein
- MP 7.01.104 – Subtalar Arthroereisis
- MP 7.01.108 – Artificial Intervertebral Disc: Cervical Spine
- MP 7.01.110 – Vertical Expandable Prosthetic Titanium Rib
- MP 7.01.118 – Surgical Treatment of Femoroacetabular Impingement
- MP 7.01.120 – Facet Arthroplasty
- MP 7.01.126 – Image-Guided Minimally Invasive Lumbar Decompression for Spinal Stenosis
- MP 7.01.130 – Axial Lumbosacral Interbody Fusion
- MP 7.01.138 – Interspinous Fixation (Fusion) Devices
- MP 7.01.139 – Peripheral Subcutaneous Field Stimulation
- MP 7.01.143 – Responsive Neurostimulation for the Treatment of Refractory Partial Epilepsy
- MP 7.01.145 – Laminectomy
- MP 7.01.146 – Discectomy
- MP 7.01.15 – Meniscal Allografts and Other Meniscal Implants
- MP 7.01.18 – Automated Percutaneous and Endoscopic Discectomy
- MP 7.01.20 – Vagus Nerve Stimulation
- MP 7.01.48 – Autologous Chondrocyte Implantation for Focal Articular Cartilage Lesions
- MP 7.01.541 – Lumbar Spine Fusion
- MP 7.01.58 – Intraoperative Neurophsyiologic Monitoring
- MP 7.01.63 – Deep Brain Stimulation
- MP 7.01.69 – Sacral Nerve Neuromodulation/Stimulation
- MP 7.01.78 – Autografts and Allografts in the Treatment of Focal Articular Cartilage Lesions
- MP 7.01.80 – Hip Resurfacing
- MP 7.01.81 – Nerve Graft in Association with Radical Prostatectomy
- MP 7.01.85 – Electrical Stimulation of the Spine as an Adjunct to Spinal Fusion Procedures
- MP 7.01.87 – Artificial Intervertebral Disc:Lumbar Spine
- MP 7.01.96 – Computer-Assisted Musculoskeletal Surgical Navigational Orthopedic Procedure
- MP 7.03 – Transplant Introduction
- MP 8.01 – Therapy Introduction
- MP 8.01.17 – Hematopoietic Stem-Cell Transplantation for Plasma Cell Dyscrasia
- MP 8.01.19 – Treatment of Hyperhidrosis
- MP 8.01.39 – Treatment of Tinnitus
- MP 8.01.40 – Manipulation Under Anesthesia
- MP 8.03.09 – Vertebral Axial Decompression
- MP 9.03.18 – Optical Coherence Tomography of the Anterior Eye Segment
- PAP 100 – Contact Information
- PAP 205 – Referring Provider Number Requirements
- PAP 210 – Diabetic Education and Nutrition
- PAP 213 – Claim Submission for Future Dates
- PAP 215 – Provider Liability
- PAP 216 – Surgical Suites
- PAP 220 – CPT Modifiers 26 and TC
- PAP 223 – CPT Modifier 25
- PAP 224 – Place of Service
- PAP 226 – Category II CPT Codes
- PAP 230 – Provider Information Changes
- PAP 235 – Anesthesia
- PAP 238 – Newborn Metabolic Screening Kit
- PAP 239 – Claim Submission of a Right and Left Modifier
- PAP 240 – Request for Medical Necessity on Elective Procedure
- PAP 250 – Facility Claim Submission Number Requirements
- PAP 260 – Implantable Device Audit Procedure
- PAP 279 – Clinical Criteria
- PAP 282 – Member Rights
- PAP 287 – Required Use of Participating Laboratories
- PAP 503 – CPT Modifier 47
- PAP 504 – Anesthesia Injections
- PAP 902 – Behavioral Health Prior Authorization Requirements
- PAP237 – V Diagnosis Codes for services prior to 10/01/2015
- PAP290 – Tribal Limited Cost Share Policy Referral Requirements
Click here to view the Blue Cross Idaho Medical Policy Updates »
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